Affiliations: [a] Department of Physical Medicine and Rehabilitation,
University of Liege, Belgium | [b] Rehabilitation Center of La Gleize, Belgium | [c] Oxygen Biochemistry Center and Fund for Medical
Research, University of Liege, Belgium
Note: [] Address for correspondence: J.L. Croisier, Department of
Physical Medicine and Rehabilitation, CHU Liege (Sart Tilman, B35), 4000 Liege,
Belgium. Tel.: +32 4 366 38 91; Fax: 32 4 366 72 30; E-mail:
jlcroisier@ulg.ac.be
Abstract: The objectives of the study were to measure the isokinetic strength
of the hip flexor-extensor and adductor-abductor muscle groups in unilateral
lower limb amputees and to evaluate abnormalities in order to improve the usual
rehabilitation programs. Thirty-three patients with unilateral lower limb amputation were
included in this study; they served as their own controls, the amputated side
being compared to the intact side. Using an isokinetic device, the relative
peak torques (N.m by body weight), bilateral asymmetries and agonist/antagonist
torque ratios were calculated for the hip flexor, extensor, adductor and
abductor muscle groups. A significant reduction of mean concentric relative peak torque
measured on the amputated limbs was generally observed when compared to the
intact contralateral limb (p < 0.05). The mean percentage of
relative peak torque decrease was greater for the extensors than for the
flexors (33 ± 20% angular velocity), and for the
abductors than for the adductors (23 ± 22% Furthermore,
the flexor/extensor torque ratio was significantly increased for the amputated
limb (for instance, 1.25 ± 0.33> versus 1.09 ± 0.25 for the intact limb at 30°/s). The
reduction of the abductor/adductor ratio of the operated limb reached the level
of statistical significance at 60°/s only
(1.25 ± 0.46 versus 1.07 ± 0.36 for
the intact limb). In conclusion, isokinetic testing revealed a significant reduction
of the hip stabilizing muscle strength as a consequence of lower limb
amputation. The more marked decrease of the strength of the abductor and
extensor muscle groups, resulting in imbalances of the agonist/antagonist
strength ratios should be taken into account to adapt the conventional
rehabilitation programs.
